Renewal Application with Education Compliance Form Broker ...

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´╗┐Renewal Application with Education Compliance Form Broker Renewal Fee: $243 Salesperson Renewal Fee: $182

Online Renewal:

Mail-In Renewal:

Go to (Use a Windows-based PC with MS Internet Explorer for best viewing experience)

Log into our secure site under the Account tab with your User ID and Password.

Click the Online Services menu button in the top right corner and click Create/Resume a Renewal.

Answer Ethical Conduct and Legal History questions. Confirm and/or enter and upload your continuing education.

Pay your renewal fee online using a Visa or Mastercard. Credit card payments may not be taken over the telephone.

Print out receipt page for your records.

Complete the Renewal Application and the Continuing Education

Compliance form. Answer the Ethical Conduct and Legal History questions. Sign and date the certification on page 1. Return the forms, along with the renewal fee and copies of your

continuing education certificates, to the Division. Make the check or money order payable to The Ohio Division of Real Estate. Cash will not be accepted. Mail to: Ohio Division of Real Estate & Professional Licensing

77 S High St., 20th Fl.

Columbus, OH 43215-6133

Note: If Online Renewal is unavailable, it is the licensee's obligation to make certain the renewal is timely filed.

Renewal Reminders:

The Renewal Application and Education Compliance Form will not be

accepted earlier than 60 days prior to your due date.

If this is your first birthday since becoming licensed, your renewal is

due, however your 30 hours of continuing education are not.

Section 1: Applicant Information

I am renewing my (check one)

Broker License ($243) Salesperson License ($182)

FIRST NAME:

MI:

LAST NAME:

File Number: _______________________________ File Number: _______________________________

DOB:

HOME ADDRESS: CHECK IF NEW

PHONE :

CITY:

STATE:

ZIP CODE:

EMAIL ADDRESS:

Section 2: Ethical Conduct and Legal History Please attach a complete explanation for any questions answered "yes." Questions apply to all professional licenses regardless of profession

Since your most recent filing of an application for Ohio real estate licensure, renewal or transfer/reactivation application, have you:

Yes

No

Been disciplined in any manner by any public entity or professional or trade association for any violation of any professional licensing law, regulation or ethical rule, including the Ohio Division of Real Estate?

Yes No Been refused or denied any professional license or registration by any public entity, including the Ohio Division of Real Estate?

Yes No Had any professional license revoked, suspended or limited in any way for any reason, including the Ohio Division of Real Estate?

Yes

No

Been notified by any public entity or professional or trade association that you were under investigation for any violation of any professional licensing law, regulation or ethical rule, including the Ohio Division of Real Estate?

Yes No Been the subject of any unsatisfied judgments?

Yes

No

Been convicted of, plead guilty to or been granted intervention in lieu of conviction for any unlawful conduct excluding minor traffic violations?

Section 3: Applicant Certification

I certify that all of the statements on this application and all of the attached materials are complete and accurate. I understand that any false statement on this form or any attached materials may subject me to criminal prosecution and the loss of my Ohio real estate license.

Signature of Applicant:X_______________________________ Date:_______________________

COM 3681 (Rev. 7/2020)

"An Equal Opportunity Employer and Service Provider"

Page 1

Real Estate Continuing Education Compliance Form

Proof of continuing education compliance may not be submitted earlier than 60 days before the licensee's due date.

Each ACTIVE LICENSEE, regardless of license status, shall submit proof to the Superintendent that the licensee has satisfactorily completed 30 hours of continuing education, including the three required courses, Civil rights, Core Law and Ohio Canons of Ethics (all 3 hours each). All brokers and management level licensees will also be required to complete a 3-hour Broker Responsibility course for a total of 12 hours of required core courses.

Each INACTIVE BROKER who is 70 yrs. of age or older on their renewal birthday must only complete the 3-hour Broker Responsibility course and submit proof of completion at the time of renewal.

Each ACTIVE LICENSEE who is 70 yrs. of age or older on their renewal birthday shall submit proof they have completed the three required courses (total of 9 hours) in Civil Rights, Core Law and Ohio Canons of Ethics. Additionally, all active brokers and management level licensees must also submit the 3-hour Broker Responsibility course for a total of 12 hours of required core courses.

Each INACTIVE SALESPERSON who is 70 yrs. of age or older on their renewal birthday does not need to complete continuing education until reactivation.

Should you have any questions regarding your requirements, please call our customer service at (614) 466-4100.

? Enter your name and file number (license number). ? List each course completed by completed the fields listed below.

? Attach copies of your education certificates ? Continuing Education Course Certificates must be maintained for a period of at least 6 years. ? Carry-Over Hours:

List carry-over from your last reporting period, which you are using this reporting period under the Electives Section.

List hours that you took this reporting period in excess of 30 hours in the Carry-Over Section, up to 10 hours.

Full Name:

File Number:

Civil Rights Course (Minimum 3 Hours) Course Provider

Ohio Certification Number

Hours

Course Title

Date(s) of Attendance

Core Law Course (Minimum 3 Hours) Course Provider

Course Title

Ohio Certification Number Date(s) of Attendance

Hours

Canons of Ethics Course (Minimum 3 Hours) Course Provider

Course Title

Ohio Certification Number Date(s) of Attendance

Hours

Broker Responsibilities (Minimum 3 Hours) Course Provider

Course Title

Ohio Certification Number Date(s) of Attendance

Hours

Electives Course Provider

Course Title

Ohio Certification Number Date(s) of Attendance

Hours

77 South High Street 20th Floor Columbus, Ohio 43215 Rev. 7/2020

An Equal Opportunity Employer and Service Provider

614-466-4100 Fax 614 -644-0584 TTY/TDD 800-750-0750

com. Page 2 of 3

Electives Course Provider Course Title Course Provider Course Title Course Provider Course Title Course Provider Course Title Course Provider Course Title Course Provider Course Title Course Provider Course Title

Ohio Certification Number Date(s) of Attendance Ohio Certification Number Date(s) of Attendance Ohio Certification Number Date(s) of Attendance Ohio Certification Number Date(s) of Attendance Ohio Certification Number Date(s) of Attendance Ohio Certification Number Date(s) of Attendance Ohio Certification Number Date(s) of Attendance

Hours Hours Hours Hours Hours Hours Hours

TOTAL HOURS FROM PAGES 2 & 3 (MUST be at least 30)

(Total hours for active licensees over 70 years of age must be at least 9 for Salespersons or 12 for Brokers & management level licensees)

Recalculate Hrs

LIST UP TO TEN HOURS OF CARRY-OVER EDUCATION BELOW. If you did not use all of the hours of the last class listed above to reach the 30 total hours, list that class first here with any of the carry over hours.

Course Provider

Ohio Certification Number

Hours

Course Title

Date(s) of Attendance

Course Provider Course Title

Ohio Certification Number Date(s) of Attendance

Hours

Course Provider Course Title

Ohio Certification Number Date(s) of Attendance

Hours

Total Number of Carry-Over Hours

Recalculate Hrs

NOTICE: This application and the information contained therein, except for the social security number, is public record pursuant to Ohio Revised Code 149.43. NOTICE: Refusal of check payment by the drawer's bank may result in a $100 fee to the superintendent or rejection or withdrawal of approval of this application.

77 South High Street

614-466-4100

20th Floor Columbus, Ohio 43215 Rev. 7/2020

Fax 614 -644-0584 TTY/TDD 800-750-0750

com.

An Equal Opportunity Employer and Service Provider

Page 3 of 3

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